Evaluation of TiNi-based wire mesh implant for abdominal wall defect management

Abstract

Purpose. Synthetic meshes are now widely used for a repair of various tissue defects. Polypropylene meshes (PPMs), the type most frequently used for repair of abdominal wall defects, have some disadvantages, therefore the development of new mesh materials for reconstructive surgery is an important topic. A TiNibased alloy superelastic mesh implant has been compared with a PPM in the Wistar rat model. Experimental. A midline resection abdominal wall defect (2 cm×3 cm) was treated with a mesh implant (2.5 cm×3.5 cm). Three groups of 20 animals were assessed: (1) a TiNi-based alloy mesh (TNM) group with the defect managed by a TiNi-based wire woven implant; (2) a PPM group with the defect repaired by Optomesh®; and (3) a no-mesh (NM) group treated without the use of any prosthetic material for systemic reaction to implant control. Evaluation of both mesh implantations was carried out on days 14, 28, 56 and 90 after surgery. The following data were compared: general condition of the animals, macroscopic evaluation of the implant area and microscopic evaluation of the tissue surrounding the mesh with the use of scanning electron and light optical microscopy. Results. All the animals from NM group developed hernias. The PPM group showed satisfactory results, although some complications like implant dislocation (6/20) and hernia recurrence (5/20) were noted. In the TNM group neither shrinkage nor implant dislocation were observed. Compared with the PPM group, the TNM group was characterized by no inflammation reaction and better integration with tissues. Conclusions. Suppression of inflammation response together with a more physiological wall remodeling process than with PPM makes TNM an attractive concept for abdominal wall defect reconstruction. Since there was neither shrinkage nor dislocation of the TNM itself it may be suitable for intraperitoneal management. The essence of enhanced biocompatibility is due to stress-strain mechanical behavior of TNM and its surface oxycarbonitride layer, which facilitate its incorporation. Summarizing, TNM was found to be a very promising material for the repair of abdominal wall defects in clinical practice. Ideally TNM would be applied in circumstances when there are indications for the management of large hernias by PPM.

Repair of Orbital Post-Traumatic Wall Defects by Custom-Made TiNi Mesh Endografts

“…The reviewed literature stresses the importance of customized design in modern reconstructive surgery, which is also relevant for the KTNM. The positive interaction between the KTNM and surrounding tissues was previously studied in animal models [7,26], and it was also assessed clinically in 120 cancer patients, as reported in Refs. [10,27], where the survivability of KTNM placed in highly virulent media was highlighted.…”

“…Each KTNM is made of the TN-10 alloy superelastic filaments (60 µm in diameter), having a microporous, oxicarbonitride superficial layer [29,30]. The bio-mimic in vitro/vivo features of TiNi-based constructs have been reported to resemble the behavior of human body tissues [26,31]. The light mesh is double knitted by a process which interlinks each filament junction and provides for superelasticity in any direction, as indicated in [10].…”

Stable composite of bacterial nanocellulose and perforated polypropylene mesh for biomedical applications

“…Optomesh is one of commercially available macroporous surgical implants. It is a nonresorbable, monofilament mesh made of polypropylene . The mesh was cut into smaller rectangular pieces in two separate directions dictated by the polypropylene fibers weaving (crosswise and lengthwise).…”

Repair of huge thoracic defect combined with hernia after multimodality treatment of breast cancer

“…Overlapping the margins by at least 5 cm, a knitted TiNi mesh was placed over the thoracoabdominal defect and secured in the standard fashion, with outer edges of the mesh folded circumferentially. The surgical mesh used was knitted of the superelastic TiNi-based alloy filament, 60 μm in diameter, with bioinert oxycarbonitride surface studied by Zaworonkow et al [ 4 ] and also reported by Anikeev et al [ 6 ]. The mesh was fixed with maximum tension around the perimeter, using a simple continuous suture technique with atraumatic 3-0 prolene suture.…”

“…In the context of a reinforcing material, customized bioadaptive TiNi-based implants are quite promising. There have already been reports of the successful use of such an approach [ [3] , [4] , [5] ].…”